埃塞俄比亚患者护理期间护理程序的实施：一项系统评价与荟萃分析

The implementation of nursing process during patient care in Ethiopia: A systematic review and meta-analysis.

作者信息

Bayih Wubet Alebachew, Ayalew Metadel Yibeltal, Belay Demeke Mesfin, Alemu Abebaw Yeshambel, Birihane Binyam Minuye, Asnakew Sintayehu, Endalamaw Aklilu, Demis Asmamaw, Kebede Solomon Demis, Abate Biruk Beletew, Baih Shegaw Zeleke, Feleke Dejen Getaneh, Mekonen Demewoz Kefale, Aynalem Yared Asmare, Aytenew Tigabu Munye, Chanie Ermias Sisay

机构信息

Department of Maternal and Neonatal Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

Department of Nursing, Pediatrics Ward, Tibebe Ghion Specialized Hospital, College of Medicine and Health Sciences, Bahir Dar University, P.O. Box 196, Bahir Dar, Ethiopia.

出版信息

Heliyon. 2021 May 1;7(5):e06933. doi: 10.1016/j.heliyon.2021.e06933. eCollection 2021 May.

DOI:10.1016/j.heliyon.2021.e06933

PMID:34007930

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8111585/

Abstract

BACKGROUND

Nursing process (NP) is a standard method of ensuring individualized holistic care through systematic assessment, diagnosis, planning, intervention and evaluation of patients. Its standard implementation is mandatory to meet the health target of "ensuring universal quality health-care services" in the sustainable development goals (SDG) launched by World Health Organization (WHO) in 2015. Being a member state of WHO, Ethiopia endorsed the SDG agenda. Therefore, determining the recent pooled estimate and associated factors of NP implementation during patient care would be of greatest importance to improve the quality of nursing care in the country.

METHODS

Primary studies were systematically searched from PubMed, Scopus, Cochrane Library, Google Scholar, PsycINFO and CINAHL data bases using different search operators. Each selected primary study was critically appraised using the Joanna Briggs Institute (JBI) appraisal tool for prevalence studies. I and Q statistics were used to investigate heterogeneity. Given the substantial heterogeneity between the studies, random effects meta-analysis model was used to estimate the pooled magnitude of NP implementation. Subgroup analyses were performed for evidence of heterogeneity. Egger's test was considered to declare publication bias objectively. The PRISMA guideline was followed to report the results.

RESULTS

A total of 17 primary studies with a sample of 2,819 nurses were included in this meta-analysis. The pooled estimate of NP implementation in Ethiopia was 50.22% (95% CI: 43.39%, 57.06%) with severe statistical heterogeneity (I = 93.0%, P < 0.001) between the studies. From regional subgroup analysis, NP was least implemented in Tigray region 35.92% (95% CI: 30.86%-40.99%, I < 0.001%). Egger's test showed no statistical significance for the presence of publication bias (P = 0.23). Nurses' good knowledge of NP [(Adjusted Odds Ratio (AOR) = 13.16: 9.17-17.15], nurses' Bachelor of Science (BSC) and above level of education (AOR = 4.16; 2.32-5.99), working in a stressful environment (AOR = 0.10; -0.02-0.22), training access (AOR = 3.30; 1.79-4.82) and accessibility of facility required for NP (AOR = 6.05; 3.56-8.53) were significantly associated with NP implementation at 95 % CI.

CONCLUSIONS

It was found that only half of the nurses in Ethiopia implemented NP during patient care. Fortunately, its associated factors were modifiable. Therefore, the existing national efforts of increasing nurses' knowledge of NP and their level of education, availing facilities required for NP implementation, training access and ensuring non stressful working environment should be reinforced to meet the quality nursing care demand in Ethiopia.

PROSPERO ID

CRD42019138159.

摘要

背景

护理程序（NP）是一种通过对患者进行系统评估、诊断、计划、干预和评价来确保个性化整体护理的标准方法。2015年世界卫生组织（WHO）发起的可持续发展目标（SDG）中，其标准实施对于实现“确保全民获得优质医疗服务”这一卫生目标至关重要。作为WHO的成员国，埃塞俄比亚认可了SDG议程。因此，确定患者护理期间NP实施的近期汇总估计值及相关因素对于提高该国护理质量极为重要。

方法

使用不同的检索运算符，从PubMed、Scopus、Cochrane图书馆、谷歌学术、PsycINFO和CINAHL数据库中系统检索原始研究。每项入选的原始研究均使用乔安娜·布里格斯研究所（JBI）的患病率研究评估工具进行严格评价。采用I和Q统计量来研究异质性。鉴于研究之间存在显著异质性，使用随机效应荟萃分析模型来估计NP实施的汇总程度。进行亚组分析以寻找异质性证据。采用Egger检验来客观判定发表偏倚。结果报告遵循PRISMA指南。

结果

本荟萃分析共纳入17项原始研究，样本为2819名护士。埃塞俄比亚NP实施的汇总估计值为50.22%（95%CI：43.39%，57.06%），研究之间存在严重的统计学异质性（I=93.0%，P<0.001）。从区域亚组分析来看，提格雷地区NP实施率最低，为35.92%（95%CI：30.86%-40.99%，I<0.001%）。Egger检验显示发表偏倚不存在统计学意义（P=0.23）。护士对NP的良好认知（调整优势比[AOR]=13.16：9.17-17.15）、护士拥有理学学士及以上学历（AOR=4.16；2.32-5.99）、在压力环境下工作（AOR=0.10；-0.02-0.22）、接受培训的机会（AOR=3.30；1.79-4.82）以及NP所需设施的可及性（AOR=6.05；3.56-8.53）在95%CI时与NP实施显著相关。